Enrollment - Care Coordinator Specialist

Job Summary

Under the direction of the Health Access Enrollment Manager and or the Director of 330 Compliance, the Care Coordinator Specialists provides program application assistance and enabling services for patients needing or requesting this type of help. The CCS provides comprehensive assessment of families and individuals needing healthcare coverage in a manner that is compassionate and sensitive to their needs. The CCS assists eligible parties with the application process, conducts timely and thorough and assists the applicant to overcome barriers within the defined guidelines, duties and responsibilities. Provides individual and community orientation as to the availability of programs that assists the uninsured or underinsured to obtain healthcare coverage or other public programs and services. As directed, may participate in events, give presentations and conduct one-on-one orientation.

Duties/Responsibilities:

1. Demonstrates thorough knowledge of available public programs, including but not limited to Covered California, Medi-Cal, FamilyPACT, Every Women Counts, Sliding Fee, Presumptive Eligibility and others as available and applicable.

2. Thoroughly and accurately assesses low to moderate income families for eligibility and qualifications for public funded programs and other assistance. Promotes program application as an opportunity for healthcare coverage.

3. Able to accurately assess eligibility for the Sliding Fee program. May be required to assist with patient registration completion.

4. Provides application assistance for public programs. Demonstrates thorough knowledge of all software, practice management systems and program guidelines used to perform these functions.

5. Conducts appropriate and thorough follow-up of pending eligibility and conducts appropriate follow-up problem solving interventions. Supports program renewal processes and assists with completion of forms or document submission. Ensures utilization of services.

6. Assists applicants with completing the Health Plan Enrollment and the selection of a health plan and/or PCP. Helps patients with PCP transfers.

7. Troubleshoots problem cases and assists with communications to resolve any barriers. Communicates effectively with program representatives and/or eligibility workers to identify interventions that assist the applicant with completion of the process. Is able to conduct three-way phone calls efficiently and effectively as needed.

8. Demonstrates thorough knowledge and understanding of the health care system and services. Facilitates access to healthcare services by informing the applicant of their benefits and services available to them. Informs patients and the community of the importance of obtaining preventive health and facilitates appointment scheduling and assists with coordinating transportation as needed.

9. Efficiently and accurately documents all activities and interventions within the systems provided. Maintains an acceptable level of productivity.

• Assist in any other duties or responsibilities as assigned.

Professional Requirements

• Adhere to dress code, appearance is neat and clean.
• Maintains all required certifications
• Maintains patient confidentiality at all times.
• Report to work on time and as scheduled as attendance and punctuality is necessary
• Ability to work with a multidisciplinary team.
• Ability to problem solve and be self-motivated.
• Maintain regulatory requirements, including all state, federal and local regulations.
• Represent the organization in a positive and professional manner at all times.
• Comply with all organizational policies and standards regarding ethical business practices.
• Communicate the mission, ethics and goals of the organization.
• Must have excellent written and oral skills, strong organizational, problem solving and analytical skills.
• Expected to have strong interpersonal skills, strong organizational, problem solving and analytical skills.
• Able to work independently with little or no supervision.
• Abides by organizational policies and procedures.

Qualifications

• College education, high school diploma, or equivalent
• CEC Certification preferred and required annual renewal once certified.
• 2 years field experience in the healthcare industry
• 2 years experience in application assistance, case management or care coordination.

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Knowledge, Skills, and Abilities

• Excellent people skills, with an ability to partner with a dynamic leadership team.
• Excellent and accurate communication skills, including verbal, written and telephone manner
• Possess personal qualities of integrity, credibility, and commitment to corporate mission.
• Flexible and able to multitask; can work within an ambiguous, fast-moving environment, while also driving toward clarity and solutions; demonstrated resourcefulness in setting priorities.
• Maintain current knowledge of policies and procedures as they relate to safe work practices.
• Follow all safety procedures and report unsafe conditions.
• Ability to work with a diverse population.
• Willing to work flexible hours, including evenings and weekends
• Must have reliable transportation and valid CA driver's license and an insurable DMV record.
• Must be self-directed and work productively with minimal supervision.
• Ability to work effectively as a member of an interdisciplinary team
• Demonstrated proficiency in using Microsoft applications such as Word, Excel, Access, Outlook
• Knowledge of Electronic Health Records preferred.
• Bilingual English/Spanish required.
• .Skilled in Microsoft Office Suite programs and use of business email.

Physical Requirements and Environmental Conditions

• Prolonged periods of sitting and working on a computer.
• Pushing and pulling objects up to 25 lbs.
• Frequent wrist, hand, and finger dexterity to perform fine motor function.
• Position requires light to moderate work with 25 lb. maximum weight to lift and carry.
• Full range of body motion requires twisting body, pushing, pulling, reaching, bending, stooping, and handling objects with hands and/or fingers, listening, talking, and/or hearing, and seeing.

Working Conditions

• Non-Ionizing Radiation (microwaves)

Work Schedule

• You will generally be scheduled to work each day Monday through Friday, with starting times varying between 8:00 a.m. and 9:00 a.m. and ending time between 5:00 p.m. and 6:00 p.m., as required to meet the operational requirements of the company. There will be occasional Saturdays or Sundays.
• You will need to travel to other clinic locations as needed for cross coverage support.
• Exempt status. Standard schedule Monday - Friday 8:00 am to 5:00 pm.
• Your regular clinic(s) will be the following location(s): Colton 308. You may need to travel to other clinic locations for meetings and other activities.
• Able to accommodate a flexible working schedule including mornings, nights, weekends, and occasional holidays